-
Environment International Oct 2023Future warming is projected to increase the heat-related mortality burden, especially for vulnerable populations. However, most previous studies focused on...
BACKGROUND
Future warming is projected to increase the heat-related mortality burden, especially for vulnerable populations. However, most previous studies focused on non-accidental morbidity or mortality, with far less research on heat-related accidental events.
METHODS
We collected individual accidental death records among all residents in Chinese mainland from June to August during 2013-2019. Accidental deaths were further divided into several subtypes by different causes. We used an individual-level, time-stratified, case-crossover study design to estimate the association between daily mean temperature and accidental deaths, and estimate its variation in seven geo-climatic zones, age (5-64, 65-74, ≥75), and sex (male, female). We then estimated the temperature-related excess accidental deaths under global warming scenarios of 1.5, 2, and 3℃.
FINDINGS
A total of 711,929 accidental death records were included in our study. We found that higher temperatures were associated with increased risks of deaths from the total accidental events and four main subtypes, including traffic, falls, drowning, and unintentional injuries. We also found that younger individuals (ages 5-64) and males faced a higher risk of heat-related mortality due to total accidents, traffic incidents, and drowning. For future climate scenarios, even under the 1.5℃ climate change scenario, 6,939 (95% eCI (empirical Confidence Interval): 6,818-7,067) excess accidental deaths per year are attributed to higher summertime daily temperature over mainland China, and the number of accidental deaths would increase by 16.71% and 33.59% under the 2℃ and 3℃ climate change scenarios, respectively. For residents living in southern coastal and northwest inland regions, the projected increase in accidental death is higher.
CONCLUSIONS
This nationwide study confirms that higher summer temperatures are linked to an increased risk of accidental deaths. Younger age groups and males face a higher risk. This indicates that current estimates of the health effects of climate change might be underestimated, particularly for younger populations.
Topics: Female; Humans; Male; China; Climate Change; Cross-Over Studies; Drowning; Hot Temperature; Temperature; Child, Preschool; Child; Adolescent; Young Adult; Adult; Middle Aged; Aged
PubMed: 37778287
DOI: 10.1016/j.envint.2023.108231 -
International Journal of Environmental... Sep 2021Limited access to health care and the lack of robust data systems means non-fatal drownings are largely missed in low-and middle-income countries. We report morbidity...
Limited access to health care and the lack of robust data systems means non-fatal drownings are largely missed in low-and middle-income countries. We report morbidity among individuals who experienced non-fatal drowning in the Barishal Division, Bangladesh. A representative household survey was conducted in the Barishal Division in southern Bangladesh between September 2016 and February 2017, covering a population of 386,016. The burden of non-fatal drowning was assessed using the WHODAS 2.0 disability assessment tool, a generic assessment instrument for health and disability. A total of 5164 non-fatal drowning events occurred in the one year preceding the survey. Among these 18% were multiple events. From these, 4235 people were administered the WHODAS 2.0 questionnaire. Non-fatal drowning incidence rates were highest in children aged 1-4 years at 5810 per 100,000 population, and among males. Non-fatal drowning was associated with lower socio-economic status and larger family sizes. Few respondents (6.5%; 95% CI: 4.5-8.4%) reported some level of disability (WHODAS-12 score > 8). Incidence of non-fatal drowning is high in the population, however limited impact on morbidity was found. There is a need to develop tools and methodologies for reliable and comparable data for non-fatal drowning, especially to capture post-event disability in children.
Topics: Bangladesh; Child; Drowning; Humans; Incidence; Infant; Male; Risk Factors; Surveys and Questionnaires
PubMed: 34574663
DOI: 10.3390/ijerph18189738 -
Annals of Saudi Medicine 2021Drowning is the third leading cause of unintentional death among children worldwide. Although natural waters pose a risk of drowning in low-income countries, swimming...
BACKGROUND
Drowning is the third leading cause of unintentional death among children worldwide. Although natural waters pose a risk of drowning in low-income countries, swimming pools are more prevalent in high-income countries. In Saudi Arabia, injuries and drowning are a significant threat to population health. Local data is limited, which affects an understanding of the extent of the burden and the development of prevention strategies.
OBJECTIVE
Determine the epidemiological characteristics, risk factors, and clinical outcomes of drowning among children.
DESIGN
Retrospective chart review.
SETTING
Patients admitted to the tertiary care unit of a hospital in Riyadh.
PATIENTS AND METHODS
Data was collected on children who drowned (age 0-14) between January 2015 and August 2020. Cases were identified from the electronic health record system where the diagnosis was drowning. Differences in characteristics and outcomes between nonfatal cases with no neurological damage and fatal cases with neurological damage were analyzed.
MAIN OUTCOME MEASURE
Drowning mortality and morbidity.
SAMPLE SIZE
99.
RESULTS
Of the 99 drowning cases, 22 (22.2%) had a fatal outcome or resulted in neurological damage. The most-reported drowning site was private pools (82%). The majority of cases involved children younger than the age of two (54%). Eighty-four cases (84.8%) occurred on holidays. Cardiopulmonary resuscitation was performed in 61 (61.6%) of cases. A significant association was found between the delay in initiating resuscitation and an unfavorable outcome (<.01). A high Glasgow Coma Scale score upon admission was a predictor of normal recovery (<.01).
CONCLUSION
These findings warrant investment to increase public awareness of the risks of leaving children unsupervised in swimming pools. In addition, there is a need to ensure early resuscitation of drowning victims by promoting life support courses in order to facilitate positive outcomes.
LIMITATIONS
The study was conducted in one tertiary center located in a non-coastal city so the results may not be generalizable.
CONFLICT OF INTEREST
None.
Topics: Adolescent; Cardiopulmonary Resuscitation; Child; Child, Preschool; Drowning; Humans; Infant; Infant, Newborn; Retrospective Studies; Saudi Arabia; Trauma Centers
PubMed: 34085546
DOI: 10.5144/0256-4947.2021.157 -
Australian and New Zealand Journal of... Apr 2023The aim of this study is to characterise Australian coastal drowning trends and evaluate impact of exposure on drowning risk.
OBJECTIVE
The aim of this study is to characterise Australian coastal drowning trends and evaluate impact of exposure on drowning risk.
METHODS
Descriptive epidemiological analysis of unintentional fatal drowning occurring July 2004-June 2021 at Australian coastal sites (beaches, rock platforms, bays, harbours, offshore locations etc.). Total population, exposed-person and exposed-person-time rates per 100,000 population were calculated by age, sex, socio-economic status, remoteness category and pre-submersion activity. Annual trends were assessed using joinpoint regression. Exposure-based rates used estimates from Surf Life Saving Australia's National Coastal Safety Survey.
RESULTS
The cumulative unintentional coastal fatal drowning rate was 0.43 per 100,000 Australian residents (95%CI: 0.41-0.45) and did not change throughout the study period (p=0.289). The exposed-person rate was 0.67 per 100,000 coastal visitors (95%CI: 0.62-0.72), and there were 0.55 coastal drowning deaths per 10 million coastal visitor hours (95%CI: 0.51-0.59). Men, older people and residents of lower socio-economic and remote areas had higher drowning rates; rock fishing and scuba diving had the highest activity exposure-based rates.
CONCLUSIONS
Education- and policy-based coastal safety interventions should focus on identified risk factors to reduce annual coastal drowning rates.
IMPLICATIONS FOR PUBLIC HEALTH
Exposure-based risk measurements are important for developing and prioritising interventions; assessments based on counts or total population measures alone may misinform prevention efforts.
Topics: Male; Humans; Aged; Australia; Drowning; Risk Factors; Educational Status; Incidence
PubMed: 36963121
DOI: 10.1016/j.anzjph.2023.100034 -
Australian and New Zealand Journal of... Jun 2024Drowning has been the focus of coastal safety, but a notable proportion of coastal mortality is due to other causes of death. This study describes that burden and...
OBJECTIVES
Drowning has been the focus of coastal safety, but a notable proportion of coastal mortality is due to other causes of death. This study describes that burden and quantifies the impact of exposure on Australian unintentional coastal fatalities not due to drowning.
METHODS
Analyses of Australian non-drowning coastal fatalities (NDCF) between July 2012 and June 2022 were conducted. Population and exposure-based rates were calculated for Australians 16+ years and compared to all-cause mortality rates. Time series analysis was performed using Joinpoint regression.
RESULTS
616 NDCFs were recorded (0.27/100,000 pop.), with a decreasing average annual percent change of -5.1% (95% CI:-9.5 to -0.4). Cardiac conditions were the primary causal factor, involved in 52% of deaths. Higher fatality rates were seen among men and for incidents occurring in rural and remote areas. Fatality rates were disproportionately high among young adults when compared to all-cause mortality.
CONCLUSIONS
Men, young adults, and those living in/visiting regional and remote areas represent high-risk populations. Proximity to emergency services and extended response times represent major determinants of NDCF.
IMPLICATIONS FOR PUBLIC HEALTH
Due to the high prevalence of NDCF, coastal safety practitioners should expand their attention beyond drowning to consider the broader range of coastal hazards and fatality types.
Topics: Humans; Male; Female; Drowning; Adult; Australia; Middle Aged; Adolescent; Young Adult; Aged; Cause of Death; Aged, 80 and over; Mortality; Risk Factors
PubMed: 38519347
DOI: 10.1016/j.anzjph.2023.100113 -
Iranian Journal of Public Health Oct 2020We aimed to assess the effectiveness of the health educational booklet intervention in improving parents/guardian's knowledge on prevention of child drowning and, the...
BACKGROUND
We aimed to assess the effectiveness of the health educational booklet intervention in improving parents/guardian's knowledge on prevention of child drowning and, the perception of drowning risk and water safety practice.
METHODS
A quasi-experimental study was conducted in year 2017 in Selangor, Malaysia among 719 parents/guardians of primary school children. The parent/guardians were randomly assigned as the intervention groups and were given a health educational Be-SAFE booklet on drowning prevention and water safety. The pretest was conducted before the intervention and posttest was done one month of intervention. The data collection tool was using a validated questionnaire on knowledge, attitude and practice for drowning prevention and water safety.
RESULTS
There were 719 respondents (response rate of 89.9%) participated at baseline and 53.7% at end line (after the intervention). Significant differences found in knowledge, attitudes and practice on drowning prevention and water safety for the intervention and control groups after the intervention (<0.001). There was a significant difference in mean scores for knowledge and attitude before and after the intervention, whereas no significant findings noted for practices (<0.001).
CONCLUSION
Be SAFE booklet contributed to the increase in parents/guardian's knowledge and attitudes towards drowning prevention and water safety to prevent the risk of child drowning.
PubMed: 33346223
DOI: 10.18502/ijph.v49i10.4695 -
Journal of Health, Population, and... Dec 2014Drowning is the commonest cause of injury-related deaths among under-five children worldwide, and 95% of deaths occur in low- and middle-income countries (LMICs) where... (Review)
Review
Drowning is the commonest cause of injury-related deaths among under-five children worldwide, and 95% of deaths occur in low- and middle-income countries (LMICs) where there are implementation gaps in the drowning prevention interventions. This article reviews common interventions for drowning prevention, introduces a framework for effective implementation of such interventions, and describes the Saving of Lives from Drowning (SoLiD) Project in Bangladesh, which is based on this framework. A review of the systematic reviews on drowning interventions was conducted, and original research articles were pulled and summarized into broad prevention categories. The implementation framework builds upon two existing frameworks and categorizes the implementing process for drowning prevention interventions into four phases: planning, engaging, executing, and evaluating. Eleven key characteristics are mapped in these phases. The framework was applied to drowning prevention projects that have been undertaken in some LMICs to illustrate major challenges to implementation. The implementation process for the SoLiD Project in Bangladesh is used as an example to illustrate the practical utilization of the framework. Drowning interventions, such as pool fencing and covering of water hazards, are effective in high-income countries; however, most of these interventions have not been tested in LMICs. The critical components of the four phases of implementing drowning prevention interventions may include: (i) planning-global funding, political will, scale, sustainability, and capacity building; (ii) engaging-coordination, involvement of appropriate individuals; (iii) executing-focused action, multisectoral actions, quality of execution; and (iv) evaluating-rigorous monitoring and evaluation. Some of the challenges to implementing drowning prevention interventions in LMICs include insufficient funds, lack of technical capacity, and limited coordination among stakeholders and implementers. The SoLiD Project in Bangladesh incorporates some of these lessons and key features of the proposed framework. The framework presented in this paper was a useful tool for implementing drowning prevention interventions in Bangladesh and may be useful for adaptation in drowning and injury prevention programmes of other LMIC settings.
Topics: Adolescent; Bangladesh; Child; Child, Preschool; Developing Countries; Drowning; Health Plan Implementation; Humans; Infant; Poverty; Risk Factors
PubMed: 25895188
DOI: No ID Found -
Medicina (Kaunas, Lithuania) Oct 2022: Aquaporins are a family of water channel proteins. In this study, the renal and intrapulmonary expression of aquaporin-5 (AQP5) was examined in forensic autopsy cases...
: Aquaporins are a family of water channel proteins. In this study, the renal and intrapulmonary expression of aquaporin-5 (AQP5) was examined in forensic autopsy cases to evaluate it as a drowning marker and to differentiate between freshwater drowning and saltwater drowning. : Cases were classified into three groups: freshwater drowning (FWD), saltwater drowning (SWD), and controls (CTR). Samples were obtained from forensic autopsies at less than 72 h postmortem (15 FWD cases, 15 SWD cases, and 17 other cases) and were subjected to histological and immunohistochemical investigations. : In FWD group, intrapulmonary AQP5 expression was significantly suppressed compared with SWD and CTR; there was no significant difference in AQP5 expression among the other two groups. The same differences in expression were also observed in the kidney. : These observations suggest that AQP5 expression in alveolar cells was suppressed by hypotonic water to prevent hemodilution. Moreover, it is possible to hypothesize that in the kidney, with the appearance of hypo-osmotic plasma, AQP5 is hypo-expressed, as a vital reaction, to regulate the renal reabsorption of water. In conclusion, the analysis of renal and intrapulmonary AQP5 expression would be forensically useful for differentiation between FWD and SWD, or between FWD and death due to other causes.
Topics: Humans; Aquaporin 5; Biomarkers; Drowning; Forensic Pathology; Fresh Water; Water
PubMed: 36295616
DOI: 10.3390/medicina58101458 -
Ulusal Travma Ve Acil Cerrahi Dergisi =... Aug 2022Traffic accidents are among the most common causes of death. A small proportion of drownings are associated with traffic accidents. The roads in the Eastern Black Sea...
BACKGROUND
Traffic accidents are among the most common causes of death. A small proportion of drownings are associated with traffic accidents. The roads in the Eastern Black Sea Region, where the study was conducted are fairly close to the seas, rivers, and ponds. This study aims to evaluate the cases who underwent autopsies after the traffic accident between 2009 and 2016 and who were found to have died as a result of drowning.
METHODS
A retrospective examination was made of the autopsy reports in the period 2009-2016.
RESULTS
As a result of the examination of forensic reports, from a total of 7124 autopsies performed in our center between 2009 and 2016, 41 (0.57%) were seen to be due to death in a traffic accident that resulted in drowning. Of the vehicles involved in the ac-cidents, 30 (73.2%) were retrieved from a river/stream, 7 (17.1%) from a lake, and 4 (9.7%) from the sea. In all 39 cases, the primary cause of death was determined as asphyxia related to drowning. Other reasons affecting death were traumatic intracranial bleeding in 7 (17.1%) cases, medulla spinalis injury in 4 (9.7%), and pulmonary injury in 2 (4.9%).
CONCLUSION
It was determined in the study that the typical autopsy results of trauma and drowning after a traffic accident could coexist. Drowning alone could be the cause of death, even though there was a traumatic origin such as a traffic accident in such cases. It was revealed that chemical and microscopic examinations should be handled together with crime scene results and eyewitness statements in addition to traumatic results during the examination phase.
Topics: Accidents; Accidents, Traffic; Automobiles; Cause of Death; Drowning; Humans; Retrospective Studies
PubMed: 35920420
DOI: 10.14744/tjtes.2021.35915 -
American Journal of Hematology May 2022
Topics: Fresh Water; Hematologic Tests; Hemolysis; Humans; Near Drowning
PubMed: 35253933
DOI: 10.1002/ajh.26514